AB1744-PARE TREATMENT ADHERENCE IN PATIENTS WITH RHEUMATOID ARTHRITIS (RA) DURING THE COVID-19 PANDEMIC
Authors: L. L. Holguín Arias, V. V. Castro Coello, C. Soliz, G. Gómez, L. Sorrentino, A. Hamaui, D. Dubinsky
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> During the last 2 years, the SAR COV2 pandemic has impacted the lifestyle, health care, physical and psychological health status of people with rheumatic diseases. In the REUMAVID study, almost half of the respondents stated that their state of health had worsened during the pandemic[1]. It's known that aspects such as fear, job loss, social isolation, uncertainty about their treatments, worsening of symptoms due to the interruption of treatment and hospital visits, increased his fatigue and pain[2]. Treatment adherence estimates in patients with RA are usually low (Between 30 and 80%)[3]. Adherence lack has been associated with worsening symptoms and increased disability<sup>[4]</sup>. <h3>Objectives</h3> The aim of this work is to evaluate SARS COV2 pandemic impact on the adherence perception in a cohort of patients with RA and their clinical associations. <h3>Methods</h3> Descriptive cross-sectional study; included patients ≥18 years old with RA (ACR/EULAR 2010 criteria), between June 1 and July 31, 2022 who gave their written consent to perform the questionnaire. Data sociodemographic, socioeconomic level (Graffar modified), clinical, laboratory, treatments, previous COVID-19 infection and vaccination status were consigned. Activity was evaluated by DAS28-PCR and functional ability with HAQ-II. Questions about the perception of the impact of the pandemic on adherence, follow-up, health status deterioration or fear of continuing treatment were included. They were measured by a visual analogue scale, with 0 being no impact and 10 being the maximum. These answers were compared with adherence measured by the Compliance Questionnaire for Rheumatology (CQR5). <h3>Results</h3> Sixty nine outpatients with RA were included. 45 patients (65%) did not perceive adherence changes during the pandemic while 24 (35%) perceive some degree of adherence disturbances. Sociodemographic characteristics are detailed in Table 1. Having an independent laboral status and the modification or suspension of work activity was statistically associated with the perception of impaired adherence (p=0.04 and 0.01 respectively). Patients with a perception of impaired adherence had significantly higher means in the VAS of affected follow-up, deterioration in their health status, and fear of infection (p= &lt;0.001, &lt;0.001 and 0.04 respectively). DAS28-PCR, HAQ-II, ERS and CRP were also significantly higher in this group (p= 0.002, 0.005, 0.01 and 0.04 respectively). No association was found between the perception of adherence disturbance and adherence measured by CQR5 (p= 0.20). <h3>Conclusion</h3> The SARS COV2 pandemic has a great impact on adherence, rheumatological follow-up and quality of life of patients with RA. Although the perception of adherence disturbance during the pandemic period is a subjective parameter, we found a significant association between this perception and higher rates of suspension or modification of work activity, greater disease activity, functional impairment, and higher acute phase reactants. Studies with a larger number of patients are needed to corroborate these findings. <h3>References</h3> [1]Garrido-Cumbrera M, Marzo-Ortega H, Christen L, et al. Assessment of impact of the COVID-19 pandemic from the perspective of patients with rheumatic and musculoskeletal diseases in Europe: results from the REUMAVID study (phase 1) RMD Open 2021;7:e001546. [2]Pope JE. What does the COVID-19 pandemic mean for rheumatology patients? Curr Treatment Opt Rheumatol. 2020;30:1-4. [3]Van den Bemt BJF, van Lankveld GJMW. How can we improve adherence to therapy by patients with rheumatoid arthritis? Nat Clin Pract Rheumatol 2007;3:68. [4]Curtis JR, Bykerk VP, Aassi M, Schiff M. Adherence and Persistence with Methotrexate in Rheumatoid Arthritis: A Systematic Review. J Rheumatol. 2016 Nov;43(11):1997-2009. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.